中国现代医学杂志2017，Vol.27Issue(28)：22-28,7.DOI:10.3969/j.issn.1005-8982.2017.28.005
不同血液净化模式对终末期肾病患者的自身免疫、炎症应激及生活质量的影响
Effect of different hemopurification types on autoimmunity, inflammation stress and quality of life in patients with end-stage renal disease
摘要
Abstract
Objective To explore the effect of different hemopurification types on autoimmunity, inflammation stress and the quality of life in patients with end-stage renal disease (ESRD) and their correlations. Methods A total of 138 cases of ESRD patients were chosen by convenience sampling method from June 2015 to June 2016 in the hemodialysis Center of Nephrology Department of the Central hospital of Enshi Autonomous prefecture. Among them 82 cases were enrolled into hemodialysis (hD) group, 39 cases into high-flux hemodialysis (hFhD) group and 17 cases into hemodiafiltration (hDF) group. The percentages of immune cells (CD4+, CD8+, CD25+, CD4+/CD8+), serum levels of C-reactive protein (CRp), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6)and tumor necrosis factor α (TNF-α), and the quality of life score were tested by flow cytometry, cell biochromatography and enzyme-linked immunosorbent assay before and 6 months after hemopurification, and then compared within a group and among different groups. Results After 6 months, the immune cells (CD4+, CD25+, CD4+/CD8+) and inflammatory factors (CRp, sIL-2R, IL-6) except for CD8+ and TNF-α were statistically different among the three groups and so were the score of subdimension and the total score of the quality of life (P < 0.05). Compared to the hD group, the levels of inflammatory factors were lowered, the content of immune cells and the subdimensional and total scores of the quality of life increased in the hDF group and the hFhD group, there were statistical significance. Among them, the immune cell levels and the subdimensional and total scores of the quality of life increased most significantly in the hFhD group, which were statistically different from those in the hDF group; the levels of the inflammatory factors dropped the most in the hDF group, which were not statistically different from those in the hFhD group. The levels of immune cells and inflammatory factors and the subdimensional and total scores of the quality of life were statistically different before and after treatment in the hDF and hFhD groups. The results of correlation analysis showed that immune cells (CD4+, CD25+, CD4+/CD8+) and inflammatory factors (CRp, sIL-2R, IL-6) were not correlated with the quality of life in the hD group (P > 0.05), were in moderately to highly positive and moderately negative correlations with the quality of life in the hFhD group and in moderately positive and negative correlations with the quality of life in the hDF group (P < 0.05). Conclusions Both hDF and hFhD can lower the levels of inflammation factors, increase immunity cell levels and improve the quality of life of ESRD patients; however, the effect of hFhD is better.关键词
血液净化/免疫细胞/炎症因子/生存质量Key words
hemopurification/immune cell/inflammatory factor/quality of life分类
医药卫生引用本文复制引用
唐俊,左满花,黄德斌..不同血液净化模式对终末期肾病患者的自身免疫、炎症应激及生活质量的影响[J].中国现代医学杂志,2017,27(28):22-28,7.基金项目
国家自然科学基金面上项目(No:81560675) （No:81560675）
湖北省教育厅中青年人才项目(No:Q20161905) （No:Q20161905）
